BLOOD TRANSFUSION
DEFINITION
Blood transfusion is the introduction process of transfusing the blood (whole blood or
components of blood) of whole blood such as erythrocytes, platelets, plasma into the
venous circulation Serum (RBC, platelets) and plasma (FFB, cryoprecipate).
MASSIVE BLOOD TRANSFUSION (MBT)
It is defined as the transfusion of more than 10 units of blood in a 24-hour period.
The indication for MBT is based on
• Hemorrhagic shock
• Polytrauma
• Peri-operative transfusion
PURPOSE
To restore /replace the loss blood volume.
To raise the Hb level in cases of severe anemia.
To combat infection in leucopenia.
To provide antibodies to immunocompromised.
To treat deficiencies of plasma protein, clotting factors or hemophilic globulin and platelet.
BLOOD COMPONENETS
BLOOD COMPONENTS
Whole Blood
Cell Plasma
components components
PRBC WBC Platelets
FFP Cryoprecipitate
Granulocytes Non-
RDP SDP
Granulocytes
Neutrophils
lymphocytes
Basophils
Eosinophils Monocytes
1. WHOLE BLOOD
• It is used to treat patients who need all the components
of blood.
It takes 12-24 hours for haemoglobin and hematocrit
to rise in the body after transfusion.
Storage : 2-6 degree c
Indications
Volume : 350 ml
• Blood loss due to trauma or surgery.
Expiry : 35 days
Transfusion time: 3 - 4 hours
WHOLE BLOOD
Complications
Volume overload
Transmission of blood borne diseases
Transfusion reaction STORAG
E
Hyperkalemia
Citrate intoxiction
Hypocalcemia
2. PACKED RED BLOOD CELL (PRBC)
• Red blood cells are prepared from whole blood by
removing the plasma.
• Provide twice the amount of hemoglobin as an
equivalent amount of whole blood.
Storage : 4 - 6 degree c
Volume : 300 ml
Expiry : 35 /42 days
Transfusion time: 3 - 4 hours
PACKED RED BLOOD CELL (PRBC)
Indications
• Symptomatic anemia
• Decreased bone marrow production & red cell
survival conditions STORAGE
• Bleeding
• Recommended trigger value Hb <7 gm% in the
absence of disease and 8-10 gm% with disease
Complication: Transfusion reaction
3. PLATELET
Platelet transfusion may be indicated to prevent hemorrhage in patients.
Indications
• Count is < 7000 cells /cumm regardless of clinical condition.
• count is < 10,000 / cumm with bleeding tendencies.
• count is <20,000 / cumm in unstable patient.
• count is < 50,000 / cumm before procedures/biopsies.
• In major surgery < 70000 — 80000 / cumm.
• Chemotherapy for malignancy.
• Massive transfusion.
PLATELET
Contra Indications
Thrombotic thrombocytopenic Heparin-induced
purpura (TTP) Thrombocytopenia (HIT)
BLOOD COMPONENETS - PLATELET
SDP: SDP is collected from a single donor. RDP: RDP is prepared from whole blood.
Also, called as apheresis platelets
SINGLE DONOR PLATELET (SDP) RANDOM DONOR PLATELET (RDP)
Storage: 22-24 degree C Storage: 22-24 degree C
Expiry : 5 days Expiry : 5 days
Volume: 250-300 ml Volume: 50- 60 ml
Transfusion time: 20- 30 minutes Transfusion time: 20- 30 minutes
SEPERATION OF BLOOD COMPONENETS
FRESH FROZEN PLASMA (FFP)
• Plasma is the liquid portion of blood
• Indications
• Actively bleeding and deficiency of multiple-
• coagulation factors
• Disseminated Intravascular Coagulation.
• Coagulopathy in massive transfusion.
Storage: -18 degree C
• Thrombotic Thrombocytopenic Purpura.
Expiry: 1 year
• Congenital or Acquired coagulation factor deficiencies. Volume :150-200ml
Transfusion time: 15-20 mt
CRYOPRECIPITATE
• It is a portion of plasma rich in clotting factors.
• To create cryoprecipitate, fresh frozen plasma thawed at
1–6 °C, is then centrifuged and the precipitate is collected.
Blood clotting proteins in cryoprecipitate are:
• Fibrinogen
• Factor VIII, XIII
• Von Willebrand factor
Indications
• Haemophilia
• Von Willebrand disease Storage: 18 degree C
• Hypofibrinogenaemia Expiry: 1 year
• Afibrinogenemia Volume : 20-30 ml
Transfusion time: 20-30 mt
STORAGE OF PLATELETS ,PLASMA
ABO BLOOD GROUPING SYSTEM
PROCESS FLOW
Completion
Monitoring &
Administ documenta
Blood ration tion
Collection bank
Requisition &
Consent form labelling
of sample
Patient
identification
Order
PROCESS FLOW
1. Physician Order 2. Patient Identification 3. Counselling & Consent
PROCESS FLOW
EXAMPLE - 1 EXAMPLE - 2
4. Requistion form
PROCESS FLOW
5. Collection &
6. Issue Request form
Labelling of sample
PROCESS FLOW Blood transfusion set
7. Administration
Alcohol swabs
Blood component
10ml syringe with
normal saline
IV set
Kidney tray
Normal saline 500ml
PROCESS FLOW
7. Administration
BLOOD TRANSFUSION
FORM
PROCESS FLOW 7. Administration
COLOR CODES FOR BLOOD GROUP TYPES
PROCESS FLOW
8. Blood transfusion procedure
I. PRE - PROCEDURE
• Receive the blood along with the compatibility report.
• Check for the expiry date of the blood bag. Specify on requisition if the patient is known
sero positive for HIV, HbsAg, or HCV in red ink.
• Blood bag is kept at room temperature for 15 —20 minutes before transfusion unless it is
an emergency.
8. Blood transfusion procedure PREPARATION OF THE PATIENT
Explain the procedure Arrange required articles Avoid transfusion at meal time
Encourage void before transfusion Monitor vitals Provide privacy
8. Blood transfusion procedure II. PROCEDURE
If the patient has a venflon already in position,
start transfusion
Attach the BT
set to the
venflon and
check the flow
of blood
Clean the IV cannula Flush the IV line
hub with alcohol swab
Record
vitals 1st Hour 2nd Hour 3rd Hour
PROCESS FLOW
Primary
9. Monitoring Transfusion Reaction Responsibility
STOP the transfusion START NS - IV line Inform physician Record vitals & condiction
PROCESS FLOW
Secondary
9. Monitoring Transfusion Reaction Responsibilities
1. Disconnect the IV tubing from the patient, but leave the bag and tubing attached.
Do not discard the blood.
2. Recheck the information on the blood bag and the requisition.
3. Notify the Blood Bank (blood product & batch number)
4. Return the left over blood product along with all the attached
tubing to the Blood Bank.
5. Collect, label and send the appropriate samples, to the Lab ( Urine & Blood)
6. Monitor the patient’s vital signs as ordered, until patient become stable.
9. Monitoring Transfusion Reaction
BLOOD COMPATIBILITY
FORM
EXAMPLES OF TRANSFUSION FEEDBACK FORM
IMMEDIATE ADVERSE EFFECTS OF TRANSFUSION
Febrile reactions Urticarial reactions
Anaphylactic Acute haemolytic
reactions reactions
Bacterial TRALI(Transfusion related
contamination acute lung injury)
Hypothermia Circulatory overload
10. Documentation
Date & time infusion start and ends.
Type of component and amount transfused.
Client reaction and vital signs.
BIBLIOGRAPHY
https://www.slideshare.net/rosesrred90/blood-transfusion-16397094
https://www.redcrossblood.org/donate-blood/how-to-donate/types-of-blood-
donations/blood-components.html
https://www.rch.org.au/bloodtrans/adverse_effects/Adverse_effects_of_transfusion/
https://www.who.int/bloodsafety/transfusion_services/ClinicalTransfusionPracticeGuideli
nesforMedicalInternsBangladesh.pdf
https://teachmesurgery.com/perioperative/general-complications/blood-transfusion/
https://teachmesurgery.com/perioperative/general-complications/blood-transfusion/
https://www.rch.org.au/bloodtrans/adverse_effects/Adverse_effects_of_transfusion/
